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Rx and Specialty
Providers
HME Excellence winner: PediStat . . . . . . . . . . . . . . . . . . . 18
Lofty goals at Lofta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
PHS publishes recreation guide . . . . . . . . . . . . . . . . . . . . . 18
Lawmakers question CPAP bundling plan . . . . . . . . . . . . 18
■ It's likely cooler heads
will prevail on issue of
sleep screening regs for
truckers, says Steven
Garrish. See story page 1.
18 hme news / october 2017 / www.hmenews.com
By John Andrews, Contributing e ditor
MIAMI – PediStat President
Grizzy Miller, RN, says she
knew that when she founded
the company in 1990 that pro-
viding healthcare services to
children would become more
than a job—it would become
her life.
Miller understood that being
available all the time is just the
nature of taking care of young
patients, and 27 years later she
still embraces that role.
WASHINGTON – A bipartisan group in the House
of Representatives in September was circu-
lating a congressional sign-on letter that
asks CMS to delay a CPAP bundling pilot
program from the next round of competi-
tive bidding.
The letter states a number reasons for
delaying the program, including the lack of
evidence that it will save money or enhance
care, and CMS's lack of authorization to test
alternative payment models as part of its
competitive bidding program.
"Instead, we encourage the agency to work
with Congress and stakeholders to prioritize
efforts that bring stability to the program,"
the letter states. "If the agency is interested
in reforms to ensure better compliance with
CPAP therapy and other home respiratory
care, we stand ready to work with you on
initiatives that have a greater potential to save
money and improve health outcomes."
The association has argued that bundling
a CPAP device, consumable items, mainte-
nance and service into a single monthly pay-
ment could cause disruption for providers,
could provide an incentive to furnish inferior
products, and could result in lower quality
of care.
CMS announced earlier this year that it
had added 10 new competitive bidding areas
for the CPAP product category. In five of
those CBAs, payment for CPAP devices, relat-
ed accessories and services will be made on a
bundled, non-capped monthly rental basis,
while payment in the other five CBAs will be
made on a capped monthly rental basis like
other existing CBAs.
The sign-on letter is spearheaded by Reps.
Tim Walberg, R-Minn., Debbie Dingell,
D-Mich., Cathy McMorris Rodgers, R-Wash.,
Scott Peters, D-Calif., and Michael Bishop,
R-Mich.
hme
By Kelly Bothum, Contributing w riter
M
e DICA l PR o B le MS are only one hurdle for families
raising children with special needs. It can be just as
challenging to find places to play, shop and eat that
not only accommodate wheelchairs and other medical devices
but welcome them as part of an inclusive atmosphere.
Pediatric Home Services, a children's home healthcare com-
pany in Minnesota, is trying to make the search easier with its
inaugural PHS Top Spots, an online guide featuring the most
accessible recreation areas, welcoming downtowns and helpful
By t heres A Fl A herty, m anaging e ditor
SAN DIEGO – New provider Jay
l evitt wants to revolutionize
the sleep therapy space with a
streamlined path to treatment
and "shockingly" good cus-
tomer service.
"We've created a holistic
experience that people can
navigate in under a week for
screening, testing, diagnosis and
treatment," said l evitt, founder
of l ofta. "I just got off the phone
with a man who has been put-
ting off getting tested for 10 years
because the thought of going to
sleep labs and doctors and all
of these other fragmented inef-
ficient steps taking 60 days are a
nonstarter."
At press time, l ofta's full
launch was about 90 to 120 days
out, but l evitt says he's already
fielding calls from consumers
attracted to the company's "Com-
plete Path" program, which takes
patients from screening to diag-
nosis to therapy in a week or less.
Seventy percent of people don't
make it through the traditional
path, which can include a visit
to a sleep lab and can take much
longer, says l evitt.
"We pull them through the
(typically) arduous stage of get-
ting diagnosed and quickly move
from the problem to the solu-
tion," he said. "We pull 100%
through the path and our com-
pliance rate is in the high 90s."
The cost: $399.
"We are completely off the
Lofta carves out
'Complete Path'
" We a re e m o t i o n a l l y
involved—we're not a busi-
ness, we are here to serve our
patients with whatever they
need," said Miller, whose
Miami-based company earned
second runner-up honors in
the HM e e xcellence Awards.
"We've been around since
1990 and some of our patients
have been with us all that time.
Some of our employees have
been here for 20 years. We're
still here, doing the same thing
More than a biz
Lawmakers question CPAP bundling plan
grid with insurance," he said.
"Most people find, with copays
and deductibles, and the incon-
venience on top of it, that they'll
end up paying more to go to
sleep labs."
l ofta will only offer ResMed
sleep products, which l evitt
believes will
e n h a n c e t h e
shopping expe-
rience for cus-
t o m e r s , w h o
won't have to
wade through
thousands of
SKUs. He is par-
ticularly gung-
ho about ResMed's new AirMini,
and in August launched www.
buyminicpap.com, dedicated
exclusively to the new CPAP.
"We feel like this is the per-
fect product to bring our name to
the market," he said. "It's sexy, it's
primarily cash pay and it's got the
Apple-like feeling to it."
l ofta offers a 30-day no-risk
trial, free shipping and even a
12-month 0% interest payment
program for the AirMini—poli-
cies that will carry over to its
main e-commerce site, says
l evitt.
"It's an expensive proposition
to spend $1,000 on a CPAP," he
said. "We wanted to take the risk
out of it."
l evitt hopes his entry into the
sleep space will also help change
the larger conversation about
sleep apnea, which he says still
has a stigma associated with it.
"We are trying to come at it
more from a wellness stand-
point," he said. "This is good
stuff to talk about: If you have
sleep apnea and you treat it, it's
such a life changer."
hme
PHS lists top spots
P H S g u i d e s e e n e x t pa g e
P E D I S TAT s e e n e x t pa g e
Grizzy m iller, right, front row, and the team at PediStat .
Jay Levitt
"We've created a holistic
experience that people can
navigate in under a week
for screening, testing,
diagnosis and treatment'
pediatrics
Briefs
Dexcom ships G5 to
m edicare beneficiaries
SAN DIEGO – Dexcom has begun shipping the
Dexcom G5 to Medicare beneficiaries who
meet coverage requirements for continu-
ous glucose monitoring, according to news
reports. CMS in January classified "thera-
peutic" CGMs as DME, paving the way for
coverage if certain criteria are met. In July,
Dexcom reached an agreement with As-
censia Diabetes Care to bundle Ascensia's
ContourNext One glucose monitoring sys-
tem with the G5. CMS has set a one-time
fee of $236 to $277 for the CGM receiver,
and a monthly allowable of $248.38 for re-
lated accessories. Demand for the G5 is so
high that 20,000 beneficiaries are "in the
pipeline" for a device. The G5 is currently
the only CGM approved for insulin dosing.
Aeroflow forms
advocacy group
ASHEVILLE, N.C. – Aeroflow Healthcare today
announced that it has formed a breast-
feeding advocacy department to promote
access to breastfeeding support, supplies
and services for families nationwide. With
the introduction of this team, the company
expands its advocacy efforts for healthy
families, aiming to increase breastfeeding
rates on both a local and national scale.
In February, Aeroflow, which has a Mom
& Baby division, launched a petition to
keep breastfeeding support as a preven-
tive health benefit.
Greater n ebraska
h ome Infusion fills need
GRAND ISLAND, Neb. – When a local phar-
macy that provided home infusion services
closed, Rick and Cindy Lobeda, who have
owned Midwest LTC Pharmacy for 10
years, saw a need and opened Greater Ne-
braska Home Infusion. They opened their
doors earlier this year, but they only recently
completed the paperwork to get their ser-
vices approved by Medicare, according to
the Grand Island Independent. "We wanted
to provide a better service and take care
of those customers the other pharmacy
has had over the years, so they didn't have
to lose a good service," Cindy Lobeda, a
licensed pharmacist, told the newspaper.
In addition to providing home infusion ser-
vices, Greater Nebraska Home Infusion has
three infusion suites. The company also of-
fers total protein nutrition.
Accredo passes
muster with o IG
WASHINGTON – Accredo Health Group has
properly billed Medicare for inhalation
drugs, according to a report from the Office
of Inspector General. The review follows the
inclusion of inhalation drugs in the top 20
DME products with the highest improper
payment rates for calendar years 2014-15.
Accredo is the first of three providers that
will undergo reviews by the OIG. Medicare
paid about $1.3 billion for inhalation drugs
during 2014-15, with Accredo receiving
26% of payments.